低炎症饮食与多种疾病轨迹的关联：一项大型基于社区的纵向研究。

The association of a low-inflammatory diet with the trajectory of multimorbidity: a large community-based longitudinal study.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.

Department of Preventive Medicine, Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

出版信息

Am J Clin Nutr. 2024 Nov;120(5):1185-1194. doi: 10.1016/j.ajcnut.2024.08.029. Epub 2024 Aug 31.

DOI:10.1016/j.ajcnut.2024.08.029

PMID:39218306

Abstract

BACKGROUND

A proinflammatory diet has been associated with a risk of individual chronic diseases, however, evidence on the association between inflammatory dietary patterns and the trajectory of chronic disease multimorbidity is sparse.

OBJECTIVES

We aimed to investigate the associations of a low-inflammatory diet with the multimorbidity trajectory.

METHODS

Within the UK Biobank, 102,424 chronic disease-free participants (mean age 54.7 ± 7.9 y, 54.8% female) were followed up to detect multimorbidity trajectory (annual change in the number of 59 chronic diseases). Baseline inflammatory diet index (IDI) and empirical dietary inflammatory pattern (EDIP) were separately calculated from the weighted sum of 32 posteriori-derived (15 anti-inflammatory) and 18 prior-defined (9 anti-inflammatory) food groups, and tertiled as low-, moderate-, and high-inflammatory diet. Data were analyzed using linear mixed effects model, Cox model, and Laplace regression with adjustment for potential confounders.

RESULTS

During the follow-up (median 10.23 y), 15,672 and 35,801 participants developed 1 and 2+ chronic conditions, respectively. Adherence to a low-inflammatory diet was associated with decreased multimorbidity risk (hazard ratio [HR] = 0.84, 95% confidence interval [CI]: 0.81, 0.86; HR = 0.91, 95% CI: 0.89, 0.94) and a slower multimorbidity accumulation (β = -0.033, 95% CI: -0.036, -0.029; β = -0.006, 95% CI: -0.010, -0.003) compared with a high-inflammatory diet, especially in participants aged > 60 y (β = -0.051, 95% CI: -0.059, -0.042; β = -0.020, 95% CI: -0.029, -0.012; both P-interactions < 0.05). The 50th percentile difference (95% CI) of chronic disease-free survival time was prolonged by 0.81 (0.64, 0.97) and 0.49 (0.34, 0.64) y for participants with a low IDI and EDIP, respectively. Higher IDI and EDIP were associated with the development of 4 and 3 multimorbidity clusters (especially for cardiometabolic diseases), respectively.

CONCLUSIONS

A low-inflammatory diet is associated with a lower risk and slower accumulation of multimorbidity (especially in participants aged > 60 y). A low-inflammatory diet may prolong chronic disease-free survival time.

摘要

背景

促炎饮食与个体慢性病风险相关，但有关炎症饮食模式与慢性病多种疾病轨迹之间关联的证据很少。

目的

本研究旨在调查低炎症饮食与多种疾病轨迹之间的关联。

方法

在英国生物库中，纳入了 102424 名无慢性疾病的参与者（平均年龄 54.7±7.9 岁，54.8%为女性），随访以检测多种疾病轨迹（59 种慢性疾病数量的年度变化）。基线炎症饮食指数（IDI）和经验性饮食炎症模式（EDIP）分别根据 32 种后验衍生（15 种抗炎）和 18 种预先定义（9 种抗炎）食物组的加权总和计算，并分为低、中、高三级炎症饮食。使用线性混合效应模型、Cox 模型和拉普拉斯回归分析数据，同时调整潜在混杂因素。

结果

在随访期间（中位时间 10.23 年），15672 名和 35801 名参与者分别发生了 1 种和 2 种以上的慢性疾病。与高炎症饮食相比，坚持低炎症饮食与较低的多种疾病风险（风险比 [HR] = 0.84，95%置信区间 [CI]：0.81，0.86；HR = 0.91，95% CI：0.89，0.94）和较慢的多种疾病累积（β = -0.033，95% CI：-0.036，-0.029；β = -0.006，95% CI：-0.010，-0.003）相关，尤其是在年龄 > 60 岁的参与者中（β = -0.051，95% CI：-0.059，-0.042；β = -0.020，95% CI：-0.029，-0.012；两者的 P 交互作用 < 0.05）。与高炎症饮食相比，低 IDI 和 EDIP 组的无慢性病生存时间的第 50 百分位数差异（95% CI）分别延长了 0.81（0.64，0.97）和 0.49（0.34，0.64）年。较高的 IDI 和 EDIP 与 4 种和 3 种多种疾病簇的发生相关（尤其是与心血管代谢疾病相关）。